Check all of the following that apply: (Be honest- remember, we’re not concerned with what you’ve done in the past, but rather want to get an honest feel for where you are today so we can tailor the program to meet your needs.)

q       I regularly use at least one of the strategies I learned in the Short Sale Queen's Success Systems.

q       I have at least one reliable marketing strategy that consistently generates new business for me.

q       I have written financial and business goals.

q       I have written goals for other areas of my life.

q       I regularly take long weekends, vacations, or other time off to “rejuvenate” myself.

Part II: Tell Us About Your Business"

Rate the following on a scale from 1-5, according to how much of a challenge they are for you:    

(1=A big problem for you, 2=Medium Problem, 3=Somewhat of a problem, 4= Rarely, 5= Not a problem at all for you)

___ Generating New Sellers                                                ____Raising Prices                                 

___ Structuring my business so it runs smoothly and I don’t have to get bogged down in busy work

___Leading a BALANCED life and taking as much time off as I’d like.

Number of hours you work weekly?    ______________                      Weeks of vacation you’ll take this year?   __________

Number of hours you’d LIKE to work weekly? _______                     Weeks off you’d LIKE to have each year?  _________

Personal net income in the past 12 months: ___$2500-25,000___ $25,000-$50,000   ___ $50,001-$100,000 ___ $100,001-$200,000  ___$200,001+

How much would you like to increase your gross income in the next 12 months? $___________________________

If I continue with my business in the direction it’s going I’ll be financially independent in 3-5 years. ___yes ___no

Answer the following questions using one of either, (Often, Sometimes, Rarely or Never.)

I feel guilty taking time off. ________________

I’m very confident in my ability to hire and train new employees. ___________________

If my school’s class reunion was next month, I’d feel excited about going. ____Yes _____No

I feel guilty about not giving enough time to my spouse, children or other relationships in my life. __________________

Briefly describe why you feel you’re a good candidate for this program: (Use the back if necessary).

_________________________________________________________________________

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PART III: PLEASE TELL US HOW TO CONTACT YOU IF YOU’RE ACCEPTED INTO THIS ELITE

Your name:__________________________________ Company: ___________________________________________

Mailing Address (incl. city, state, zip); _________________________________________________________________   

Phone: _________________________ FAX: ___________________________  E-mail: _________________________

Your Final Step: Complete this application and

FAX it to 513-868-8886

or Mail it to: Short Sale Queen, 3729 Riva Ridge Drive, Hamilton,  OH 45011

No payment information is required at this time. This form is for evaluation purposes only.

We will notify you by fax or phone within 9 days if you are qualified to move on to the next step of the application process for this program.